Needs-based planning for generalist physicians

The Manitoba Centre for Health Policy and Evaluation (MCHPE) collaborated with a provincially-appointed Physician Resource Committee in an assessment of provincial physician resources.

Beginning with map-based analyses of physician supply and contacts across the province, compared with the health and socioeconomic characteristics of local populations, the study moved to a needs-based, regression-based approach to physician resource planning.

The results challenged the popular belief that Manitoba suffers from an increasing shortage of physicians. A handful of high-need, low-supply and low-use areas are identified, as is the expensive surplus of generalist physicians in Winnipeg. (Generalist physicians include general and family practitioners as well as general internists and pediatricians.) No relationship between physician supply and health characteristics of populations, or between high physician supply and low hospital use patterns were found. Given the Committee's interest in what drives high physician contact rates, analyses of visit patterns of hypertensive patients were undertaken. We found that patients who had more complex medical conditions made more contacts, but that after controlling for this and other key patient characteristics, the patient's primary care physician's patient recall rate was a strong influence on how frequently visits were made.